R. van Winkel (R.)http://repub.eur.nl/ppl/35731/
List of Publicationsenhttp://repub.eur.nl/eur_signature.pnghttp://repub.eur.nl/
RePub, Erasmus University RepositoryEarly trauma and familial risk in the development of the extended psychosis phenotype in adolescencehttp://repub.eur.nl/pub/37630/
Mon, 01 Oct 2012 00:00:01 GMT<div>J.T.W. Wigman</div><div>R. van Winkel</div><div>J. Ormel</div><div>F.C. Verhulst</div><div>J. van Os</div><div>W.A.M. Vollebergh</div>
Objective: Both genetic and environmental factors are thought to play a role in the development of psychotic outcomes; however, their respective contributions over time, including possible developmental interactions, remain largely unknown. Method: The contribution of parental general and psychotic psychopathology as proxies of genetic risk to the development of subthreshold psychosis and its hypothesized interaction with childhood trauma were studied in a general population sample of 2230 adolescents, followed from age 10-16years. Outcome measures were: i) level of psychotic experiences at age 16years and ii) persistence of such experiences over the total follow-up period. Results: General parental psychopathology was associated with CAPE score (OR=1.08; P<0.043 for highest quintile) and suggestively predicted psychosis persistence (OR, 1.16; P<0.072). Psychotic parental psychopathology was suggestively associated with CAPE score (OR, 2.25; P<0.063 for highest quintile), predicted membership of the Persistent group (OR, 3.72; P<0.039) and suggestively predicted membership of the Decreasing group (OR 2.04; P<0.051). Childhood trauma was associated with CAPE score and with all developmental trajectories of subclinical psychosis. No evidence was found for an interaction between trauma and parental psychopathology. Conclusion: The development and persistence of subthreshold psychotic symptoms may be conditional on non-interacting proxy genetic and environmental influences. Incident somatic comorbidity after psychosis: Results from a retrospective cohort study based on Flemish general practice datahttp://repub.eur.nl/pub/57813/
Wed, 30 Nov 2011 00:00:01 GMT<div>C. Truyers</div><div>F. Buntinx</div><div>J. de Lepeleire</div><div>M. de Hert</div><div>R. van Winkel</div><div>B. Aertgeerts</div><div>S. Bartholomeeusen</div><div>E.M.E.H. Lesaffre</div>
Background: Psychotic conditions and especially schizophrenia, have been associated with increased morbidity and mortality. Many studies are performed in specialized settings with a strong focus on schizophrenia. Somatic comorbidity after psychosis is studied, using a general practice comorbidity registration network. Methods. Hazard ratios are presented resulting from frailty models to assess the risk of subsequent somatic disease after a diagnosis of psychosis compared to people without psychosis matched on practice, age and gender. Diseases studied are cancer, physical trauma, diabetes mellitus, gastrointestinal disorders, joint disorders, irritable bowel syndrome, general infections, metabolic disorders other than diabetes, hearing and vision problems, anemia, cardiovascular disease, alcohol abuse, lung disorders, mouth and teeth problems, sexually transmitted diseases. Results: Significant higher risks after a diagnosis of psychosis were found for the emergence of diabetes, physical trauma, gastrointestinal disorders, alcohol abuse, chronic lung disease and teeth and mouth problems. With regard to diabetes, by including the type of antipsychotic medication it is clear that the significant overall effect was largely due to the use of atypical antipsychotic medication. No significant higher risk was seen for cancer, joint conditions, irritable bowel syndrome, general infections, other metabolic conditions, hearing/vision problems, anaemia, cardiovascular disease or diabetes, in case no atypical antipsychotic medication was used. Conclusion: Significantly higher morbidity rates for some somatic conditions in patients with psychosis are apparent. People with a diagnosis of psychosis benefit from regular assessments for the emergence of somatic disorders and risk factors, including diabetes in case of atypical antipsychotic medication.AKT1 Moderation of Cannabis-Induced Cognitive Alterations in Psychotic Disorderhttp://repub.eur.nl/pub/26757/
Wed, 20 Jul 2011 00:00:01 GMT<div>R. van Winkel</div><div>N.J.M. van Beveren</div><div>C.P.M. Simons</div><div>R.S. Kahn</div><div>D. Linszen</div><div>J. van Os</div><div>D. Wiersma</div><div>R. Bruggeman</div><div>W. Cahn</div><div>L. de Haan</div><div>L. Krabbendam</div><div>I. Myin-Germeys</div>
Genetic variation in AKT1 may be associated with sensitivity to the psychotomimetic effects of cannabis as well as with increased risk for psychotic disorder following cannabis use. Investigation of the effect of this interaction on relevant intermediate phenotypes for psychosis, such as cognition, may help to clarify the underlying mechanism. Thus, verbal memory (visually presented Word Learning Task), sustained attention (Continuous Performance Test, CPT), AKT1 rs2494732 genotype, and cannabis use were examined in a large cohort of patients with psychotic disorder. No evidence was found for AKT1 × cannabis interaction on verbal memory. Cannabis use preceding onset of psychotic disorder did interact significantly with AKT1 rs2494732 genotype to affect CPT reaction time (β=8.0, SE 3.9, p=0.037) and CPT accuracy (β=-1.2, SE 0.4, p=0.003). Cannabis-using patients with the a priori vulnerability C/C genotype were slower and less accurate on the CPT, whereas cannabis-using patients with the T/T genotype had similar or better performance than non-using patients with psychotic disorder. The interaction was also apparent in patients with psychotic disorder who had not used cannabis in the 12 months preceding assessment, but was absent in the unaffected siblings of these patients and in healthy controls. In conclusion, cannabis use before onset of psychosis may have long-lasting effects on measures of sustained attention, even in the absence of current use, contingent on AKT1 rs2494732 genotype. The results suggest that long-term changes in cognition may mediate the risk-increasing effect of the AKT1 × cannabis interaction on psychotic disorder.Neuropsychopharmacology advance online publication, 20 July 2011; doi:10.1038/npp.2011.141.Evidence for a persistent, environment-dependent and deteriorating subtype of subclinical psychotic experiences: a 6-year longitudinal general population studyhttp://repub.eur.nl/pub/25973/
Mon, 11 Apr 2011 00:00:01 GMT<div>J.T.W. Wigman</div><div>R. van Winkel</div><div>Q.A.W. Raaijmakers</div><div>J. Ormel</div><div>F.C. Verhulst</div><div>S.A. Reijneveld</div><div>J. van Os</div><div>W.A.M. Vollebergh</div>
BACKGROUND: Research suggests that subclinical psychotic experiences during adolescence represent the behavioral expression of liability for psychosis. Little is known, however, about the longitudinal trajectory of liability in general population samples. METHOD: Growth mixture modeling was used to examine longitudinal trajectories of self-reported positive psychotic experiences in the Youth Self Report (YSR), completed three times over a period of 6 years by a general population cohort of adolescents aged 10-11 years at baseline (n=2230). RESULTS: Four groups with distinct developmental trajectories of low, decreasing, increasing and persistent levels of mild positive psychotic experiences were revealed. The persistent trajectory was associated strongly with cannabis use, childhood trauma, developmental problems and ethnic minority status, and consistently displayed strong associations with factors known to predict transition from subclinical psychotic experience to clinical psychotic disorder (severity of and secondary distress due to psychotic experiences, social and attentional problems and affective dysregulation) and also with high levels of parental-reported psychotic experiences and use of mental health care at the end of the follow-up period. Progressively weaker associations were found for the increasing, decreasing and low trajectories respectively. CONCLUSIONS: The results suggest that the outcome of early developmental deviation associated with later expression of psychotic experiences is contingent on the degree of later interaction with environmental risks inducing, first, persistence of psychotic experiences and, second, progression to onset of need for care and service use. Insight into the longitudinal dynamics of risk states in representative samples may contribute to the development of targeted early intervention in psychosis.